Clinical course of central nervous system demyelinating neurological adverse events associated with anti-TNF therapy

Journal of Neurology - Previous studies have reported an association between anti-tumor necrosis factor alpha (anti-TNFα) treatment and central nervous system (CNS) events. We described eight...     

Determinants of COVID-19-related lethality in multiple sclerosis: a meta-regression of observational studies

Journal of Neurology - To identify risk factors for an increased lethality of COVID-19 in patients with multiple sclerosis (MS). We searched scientific databases to identify cohort studies with the...     

Increased post-traumatic survival of neurons in IL-6-knockout mice on a background of EAE susceptibility

Fas expression increases in perinecrotic areas of glioblastoma. In this study the up-regulation of Fas/FasL by oxidative stress was shown. H(2)O(2) exposure increased Fas expression in two astrocytoma cell lines and cells became sensitive to agonistic anti-Fas antibody. FasL was up-regulated in astrocytoma cells. Apoptosis of Molt-4 cells was augmented by astrocytoma cells pretreated with H(2)O(2). Our findings suggest up-regulation of Fas in astrocytoma cells may lead them to be sensitive to apoptosis when cells are in oxidative stress. Whereas, the up-regulation of FasL may render astrocytoma cells cytotoxic to neighboring brain tissues and infiltrating immune cells.     

A new biofeedback approach for the control of masseter and temporal myalgia: Utilization of an awake posterior interocclusal device

ABSTRACT

Objective: To evaluate the improvement in reducing the pain of patients diagnosed with masticatory myofascial pain and bruxism when undergoing treatment with a partial posterior interocclusal device for the management and control of awake bruxism through biofeedback.

Methods: Sixty patients were evaluated during the following periods: pretreatment, 7, 30, and 90 days. The evaluation was carried out by measuring the reduction in pain using clinical and numerical scales.

Results: The majority of the patients who complained of masticatory myofascial pain, TMJ, and neck pain experienced a significant reduction in pain between t0 and t30 (p < 0.0001). After 30 days of using the device, the improvement remained at the same level, without any recurrence of pain up to t90.

Conclusion: The utilization of a posterior interocclusal device for the management and control of awake bruxism through biofeedback contributed to the reduction of pain in the majority of patients.     

Calcium,Parathyroid Hormone,and Vitamin D: Major Determinants of Chronic Pain in Hemodialysis Patients

Background and objectives: Pain is a frequent complaint of hemodialysis (HD) patients, yet information regarding its causes and frequency is relatively scarce. The aim of this study was to evaluate the frequency and possible causes of chronic pain in patients who are on long-term HD.Design, setting, participants, & measurements: We prospectively enrolled 100 patients who were undergoing maintenance HD for at least 3 mo. Pain was evaluated using the Brief Pain Inventory. Data collected on each participant included age, gender, ethnic origin, body mass index, smoking habits, time on dialysis, type of blood access, comorbidities, and biochemical and hematologic parameters.Results: The average age was 64.5 yr; the average time on dialysis 40.4 mo. Forty-five patients were male. Thirty-one participants were of Arabic origin. Fifty-three patients had diabetes, 36 of whom had diabetic retinopathy. Although 51 patients experienced chronic pain, only 19.6% described the pain as severe. Musculoskeletal pain, neuropathic pain, and headache were the most prevalent forms of pain. The presence of diabetic retinopathy and neuropathy (but not diabetes per se) and levels of intact parathyroid hormone, calcium, and calcitriol (but not 25-hydroxyvitamin D₃) differed significantly between those who experienced chronic pain and those who did not. On a logistic regression model, higher serum calcium levels and intact parathyroid hormone levels >250 pg/ml were independently associated with chronic pain, as well as the presence of diabetic retinopathy. Calcitriol had a marginal effect.Conclusions: Disturbed mineral metabolism is strongly associated with chronic pain in long-term HD patients, along with microangiopathy.Pain is a frequent complaint of hemodialysis (HD) patients (1–3), yet information regarding its origins, frequency, and management is relatively scarce. Most published data come indirectly from studies focusing on health-related quality of life (1,3). The reported frequency of pain varies widely in these patients. Murtagh et al. (4), in a review of symptoms in ESRD, reported a weighted mean pain prevalence of 47%, with a range of 8 to 82%.Although well-accepted guidelines are available for the management of cancer-related pain (5), no such recommendations exist for pain associated with HD. One review (6) suggested using the same step-wise approach promulgated by the World Health Organization to treat cancer pain; however, the treatment of HD patients is complicated by the need to adjust frequently the dosage of analgesic drugs and by increased risk for adverse effects (7,8). It is of no surprise, therefore, that an article from the Dialysis Outcomes and Practice Patterns Study (DOPPS) by Bailie et al. (9) reported an undertreatment of pain in HD patients. In fact, pain was not treated adequately in the majority of patients. The purpose of this study was to evaluate the frequency and possible associations of chronic pain in patients who are on long-term HD.     

Stimulation of myelin gene expression in vitro and of sciatic nerve remyelination by interleukin-6 receptor-interleukin-6 chimera

Induction of myelin gene expression denotes the last stage of differentiation of myelinating glial cells. Following peripheral nerve transection, Schwann cells (SC) lose myelin gene expression and proliferate, resembling premyelinating embryonic SC (eSC). We show that a fusion protein of the soluble interleukin-6 receptor to interleukin-6 (IL6RIL6), a potent activator of the gp130 signaling receptor, is an inducer of MBP and Po gene products in rat E18 embryonic dorsal root ganglia (DRG) 3 day cultures. Cells whose growth is dependent on the IL6RIL6 chimera were isolated from DRG. These cells (designated CH cells) express Krox-20, as do promyelinating and myelinating SC (mSC). IL6RIL6 induces Po and MBP in CH cells and their cocultures with neurons. In addition, IL6RIL6 leads to a disappearance of Pax-3, a marker of eSC and nonmyelinating Schwann cells (nmSC). Glial fibrillary acidic protein, present in nmSC, is not significantly induced by IL6RIL6. The CH cells acquire glial morphology when exposed to IL6RIL6 and cover axons in cocultures. In a sciatic nerve-derived SC line, IL6RIL6 also induces Po and triggers a rapid attachment along axons. In vivo administration of IL6RIL6 intraperitoneally to rats after sciatic nerve transection and resuture increases 4-fold the number of myelinated nerve fibers (MF) measured on day 12, 2.5-5 mm distal to the suture. The stimulation by IL6RIL6 treatment is highest (7.1-fold) at the more distant 5 mm site, and the thickness of myelin sheaths is increased. Compared to known SC growth factors, the gp130 activator IL6RIL6 appears to combine both in vitro mitogenic effects and promotion of myelin gene expression.